Is anyone else struggling with the decision to go through the public hospital system for their birth, or with a private OB?

The out of pocket costs for the OB I've booked into will be about $5.5k and I'm not sure that it's worth it.

But being my first pregnancy I don't really know what to expect, what the difference in the level of care will be, etc.

I'm only 7.5 weeks along, so too early to discuss with my friends & I don't have many girlfriends yet who have had babies. My sister delivered with a private OB in a public hospital (RPA) and was very happy with OB's care, but I believe her primary reason for going with OB was that she'd had a previous botched D & C at RPA, and was going to require a C/S to give birth safely. I want to get her advice, but I feel she'll be very anti-public hospital care because of the bad experience she had with D & C. She may have some other stories though, good & bad, from her mothers group friends, who likely went to RPA also. There appear to be quite mixed reviews about public hospital births on EB, seems to be the luck of the draw.

First OB appt is next Friday, so really need to decide in the next few days if I'm cancelling it or not. I've hedged my bets & have also booked into public hospital system. Confused!!

It's my first pregnancy too and I was just as confused. In the end, I chose private, due to many, many stories on this forum. I realise that in the majority of births, public is just fine, but I just wanted to ensure that I've taken every precaution. Especially here in Sydney, where public system is bursting at its seams.

The public hospital I initially booked into had 12 births last night (gossip at the yoga class), whilst they only have 3 or 4 birthing suites. Most of those ladies will have to share rooms now. The doula who runs the yoga class was with her woman birthing there. She told us she had to look for midwives on several occasions, the last being when the baby was already crowning - they are just terribly understuffed.

It's a highly personal decision, but the further we go, the happier we are with our decision, as our baby feels more and more precious to us.

That's exactly what I have been juggling with in the last few weeks. My first bub I went OB & private care and was very happy and I think out of pocket $2000 ish. For my second bub I was living in Shepparton, you have to deliver in the public hospital so I went through a GP who was brilliant and was at the (very long) delivery. 5 or so hours after delivery I checked in at the private. That really was the ideal situation for me as I believe (for a non complicated pregnancy) OB's are a bit overated half the time they don't even make it to the birth and obviously it was very cost effective.
So third time around I really struggled to justify the $$ to go private, if I could go GP or Midwife and private I would do that in a heart beat. I booked into Mercy for Women (Public) but cancelled today and booked with the OB who delivered my first bub and the only reason I did this is because I don't won't to be rushed home after 2 nights. I really treasure the first few days and I thought it was important i got the same time to bond with # 3. Having a baby is such a amazing time in your life that you will never forgot and I didn't want to regret making the decision based on $$.

But as far as care goes I think most public systems provide just as good care as a OB.

I think that sometimes going public and hiring a doula can be a happy medium. A doula can provide you with the continuity of care through your pregnancy that an OB does, but will attend more of your birth than most OB's do. They are not medically trained but hopefully in the public system there will be someone there that is! The give you some peace of mind that you have someone with you the whole time who ahs had some birth experience. The figures show that they really can make profound positive difference in a woman's labour- and at a fraction of the cost of an OB.

I have just had my first baby in a private hospital in Sydney.

Although it sometimes seemed like we were throwing money away by having a private OB as I had a very straight forward pregnancy, my labour was not straight forward and my OB on the day was absolutely fantastic and saved us from what could have been a very bad situation.

Yes there are OBs in the public system too but I worry with understaffing issues and them not knowing you personally.

The other advantage to going private is that you can stay longer in hospital after bub is born. While some want to get home right away, I liked being able to rest and learn to breastfeed at my own pace over the course of a week.

However it goes without saying that private OB / Private hospital you will be more likely to have intervention than in a public hospital.

I think for my next baby I will still use a private OB but will consider hiring a doula as well.

I contemplated going private with DS, but just couldn't justify the out of pocket expenses (which would have been $5000+). In the end I went public in a small hospital (shared care) but as a private patient. Being a private patient I had my choice of doctor, which was really important, but only had to pay for scans and GP appointments. I had two friends pregnant at the same time who went private, and apart from getting a scan at every ob appointment, I couldn't really detect much difference between our experiences in both pregnancy care and during the birth. One of them had an almost identical birthing experience as me (induction, baby stuck, forceps, epi, post-partum hemorage), and the levels of care we received and the processes followed seemed pretty much on par. There was no pressure for me to leave the hospital after birth, and I stayed in for 4 nights, with the midwives happy for me to stay longer if I needed to.

This. You are more likely to have an intervention free, vaginal birth if you have midwives in the public system attending you. I really didn't want intervention, so this was a big deciding factor for me. So this is something you need to consider.

The other thing to remember is that if there are big problems with you or bubs you will be transferred to a public hospital anyway.

You could also consider a birth centre or a home birth

I didn't realise there was this option to go Private in Public, did the hospital have a private section? Which state was this? This sounds like a really good option, the only reason I am choosing to go private this time is to get the longer stay.

One thing I would say is that of you're in Sydney and want to go private, you have to book pretty much now to get your choice of OB. The popular ones tend to book out quickly.

I'm also 7.5 weeks and had my 1st appointment with my OB yesterday. Could not be happier. I am happy with the one on one care and being in Sydney, like everyone says, I think the public system is overstretched, particularly popular ones like RPA. My OB operates in both systems. She has told us that in the private hospital, you will get your full 5 days, while in the public system, they are more likely to push you out quickly if you have no issues. Choice of hospital was still up to us as she operates in both.

All my friends have delivered in private care, so I really don't have any reference for the public system, but I am totally happy with my decision and I do feel that if you can afford it, the one on one care is what you are paying for. I am going to be seeing my OB every 4 weeks and then every 2 weeks nearer my birth, and every week near the due date. So, it is going to be a very close relationship. Most of my friends have said the difference is really the care leading up to birth, at birth, it is still up to you, OB or not. They are there if you need them, but you still do the work!

I don't agree with some comments on intervention, my OB is totally supportive of natural birth and every woman is different, some women prefer to be assisted and some women would prefer to have a C section, so choice is there.

ds1 we went private and whilst my OB was fantastic the hospital was horrid.

DS2 - private OB for the pregancy but delivered public hosp

M/C

D? This preg we are going straight public, we just can't afford the fee this time around. I would in a heart beat go back to our OB but finances don't allow this time.

It's a lot of money your outlaying for an ob since medicare changed there rebates

I'm in NSW. I got a private room, free TV and most importantly my choice of doctor. Because the hospital appreciates being able to charge my private health insurance for my in-hospital care, thus lessening the strain on their budget, they covered my excesses as well so I didn't receive any bills for my epidural etc. I'm not sure if this is state-wide or the policy of this particular hospital, but it seemed to be the best option I had available. My other choices were a birth centre at a large nearby hospital, the public antenatal ward at that same nearby hospital (which doesn't have a good reputation and I would have had to share a ward, even as a private patient) or 2 different private hospitals.

I've delivered both private and public. First was private and it was great. I liked the continuity of care, having almost a week in hospital after the birth and heaps of contact afterwards with the breastfeeding clinic when I was having feeding issues. And when I had troubles several weeks after the birth I rang my ob on her mobile and she arranged for me to be readmitted and did some excellent follow up which I would not have got if I presented to ED.

Second I went public as I was living in an area that did not have private. The care was fine and I did not have any issues. I did find that there was some different between the drs I saw and I thnk different drs would have made different decisions on my care depending on who I saw at the time. But nothing major. I also did not like sharing a room, both in terms of being a bit of a nightmare when I had my toddler visiting me, and not being able to sleep due to my room mate's baby crying constantly, and then feeling awful hearing the mum in tears herself most of the day. But all in all, it was fine. I also had to push for 3 nights in hospital and I was certainly pushed out, where as I would have liked more support to get BF right before leaving.

This time I'm back private with my same ob and it is just wonderful! She knows my history and I know she will be making all the decisions, rather than different people saying different things.



I have to disagree with this. I had a drug free birth and the only interventions I had came when my baby had shoulder dystocia and got stuck. My ob says her caeser rate is 20%, where I thought about a third was the general figure nowadays. So if you do your homework and know what you want it does not mean you are doomed to intervention.